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"dateModified": "2015-04-19T21:31:35Z" } }, { "key": "MBCEHWSF", "version": 143, "library": { "type": "group", "id": 334259, "name": "ALS 321 Project", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_321_project", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/334259/items/MBCEHWSF", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/MBCEHWSF", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/334259/items/SQT6NPIG", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } } }, "data": { "key": "MBCEHWSF", "version": 143, "parentItem": "SQT6NPIG", "itemType": "attachment", "linkMode": "linked_url", "title": "Microsoft Word - Inspire FDA Panel Pack 22_Jan_2014.docx - ucm386164.pdf", "accessDate": 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"type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/S84UNVB8", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } }, "creatorSummary": "Certal et al.", "parsedDate": "2014-11-01", "numChildren": 2 }, "data": { "key": "S84UNVB8", "version": 140, "itemType": "journalArticle", "title": "Hypoglossal nerve stimulation in the treatment of obstructive sleep apnea: A systematic review and meta-analysis", "creators": [ { "creatorType": "author", "firstName": "Victor F.", "lastName": "Certal" }, { "creatorType": "author", "firstName": "Soroush", "lastName": "Zaghi" }, { "creatorType": "author", "firstName": "Muhammad", "lastName": "Riaz" }, { "creatorType": "author", "firstName": "Antonio S.", "lastName": "Vieira" }, { "creatorType": "author", "firstName": "Carlos T.", "lastName": "Pinheiro" }, { "creatorType": "author", "firstName": "Clete", "lastName": "Kushida" }, { "creatorType": "author", "firstName": "Robson", "lastName": "Capasso" }, { "creatorType": "author", "firstName": "Macario", "lastName": "Camacho" } ], "abstractNote": "Objectives/Hypothesis\n\nPoor adherence to continuous positive airway pressure treatment in obstructive sleep apnea (OSA) adversely affects the effectiveness of this therapy. This study aimed to systematically review the evidence regarding the efficacy and safety of hypoglossal nerve stimulation as an alternative therapy in the treatment of OSA.\n\n\nData Sources\n\nScopus, PubMed, and Cochrane Library databases were searched (updated through September 5, 2014).\n\n\nMethods\n\nStudies were included that evaluated the efficacy of hypoglossal nerve stimulation to treat OSA in adults with outcomes for apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and effect on daytime sleepiness (Epworth Sleepiness Scale [ESS]). Tests for heterogeneity and subgroup analysis were performed.\n\n\nResults\n\nSix prospective studies with 200 patients were included in this review. At 12 months, the pooled fixed effects analysis demonstrated statistically significant reductions in AHI, ODI, and ESS mean difference of −17.51 (95% CI: −20.69 to −14.34); −13.73 (95% CI: −16.87 to −10.58), and −4.42 (95% CI: −5.39 to −3.44), respectively. Similar significant reductions were observed at 3 and 6 months. Overall, the AHI was reduced between 50% and 57%, and the ODI was reduced between 48% and 52%. Despite using different hypoglossal nerve stimulators in each subgroup analysis, no significant heterogeneity was found in any of the comparisons, suggesting equivalent efficacy regardless of the system in use.\n\n\nConclusions\n\nThis review reveals that hypoglossal nerve stimulation therapy may be considered in selected patients with OSA who fail medical treatment. Further studies comparing hypoglossal nerve stimulation with conventional therapies are needed to definitively evaluate outcomes.\n\n\nLevel of Evidence\n\nNA Laryngoscope, 2014", "publicationTitle": "The Laryngoscope", "publisher": "", "place": "", "date": "November 1, 2014", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "n/a-n/a", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "The Laryngoscope", "DOI": "10.1002/lary.25032", "citationKey": "", "url": "http://onlinelibrary.wiley.com/doi/10.1002/lary.25032/abstract", "accessDate": "2015-04-19T21:11:56Z", "PMID": "", "PMCID": "", "ISSN": "1531-4995", "archive": "", "archiveLocation": "", "shortTitle": "Hypoglossal nerve stimulation in the treatment of obstructive sleep apnea", "language": "en", "libraryCatalog": "Wiley Online Library", "callNumber": "", "rights": "© 2014 The American Laryngological, Rhinological and Otological Society, Inc.", "extra": "", "tags": [ { "tag": "Hypoglossal nerve stimulation", "type": 1 }, { "tag": "sleep apnea", "type": 1 } ], "collections": [ "BJPANI3I" ], "relations": {}, "dateAdded": "2015-04-19T21:11:56Z", "dateModified": "2015-04-19T21:11:56Z" } }, { "key": "P252ATJC", "version": 139, "library": { "type": "group", "id": 334259, "name": "ALS 321 Project", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_321_project", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/334259/items/P252ATJC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/P252ATJC", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } }, "parsedDate": "2014-06-05", "numChildren": 0 }, "data": { "key": "P252ATJC", "version": 139, "itemType": "webpage", "title": "Recently-Approved Devices > Inspire Upper Airway Stimulation - P130008", "creators": [], "abstractNote": "", "websiteTitle": "FDA - U.S. Food and Drug Administration", "websiteType": "", "date": "06/05/2014", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm398321.htm", "accessDate": "2015-04-19T21:09:12Z", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [], "collections": [ "BJPANI3I" ], "relations": {}, "dateAdded": "2015-04-19T21:09:12Z", "dateModified": "2015-04-19T21:09:58Z" } }, { "key": "UDVFWQFZ", "version": 136, "library": { "type": "group", "id": 334259, "name": "ALS 321 Project", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_321_project", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/334259/items/UDVFWQFZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/UDVFWQFZ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } }, "parsedDate": "2015", "numChildren": 1 }, "data": { "key": "UDVFWQFZ", "version": 136, "itemType": "webpage", "title": "Sleep Apnea Implant, CPAP Alternative", "creators": [], "abstractNote": "Inspire therapy is a treatment for Obstructive Sleep Apnea for those who can't use CPAP. Visit our site to learn more and find a doctor near you!", "websiteTitle": "Inspire Upper Airway Stimulation", "websiteType": "", "date": "2015", "publisher": "", "place": "", "DOI": "", "citationKey": "", "url": "https://www.inspiresleep.com/", "accessDate": "2015-03-04", "shortTitle": "", "language": "", "rights": "", "extra": "", "tags": [], "collections": [ "CW6KGNNT" ], "relations": {}, "dateAdded": "2015-03-04T21:45:09Z", "dateModified": "2015-04-19T20:59:08Z" } }, { "key": "J462C4RD", "version": 134, "library": { "type": "group", "id": 334259, "name": "ALS 321 Project", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_321_project", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/334259/items/J462C4RD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/J462C4RD", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/334259/items/W723GDV9", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } } }, "data": { "key": "J462C4RD", "version": 134, "parentItem": "W723GDV9", "itemType": "attachment", "linkMode": "linked_url", "title": "Snapshot", "accessDate": "2015-04-19T20:53:18Z", "url": "http://physrev.physiology.org/content/90/1/47", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-04-19T20:53:18Z", "dateModified": "2015-04-19T20:53:18Z" } }, { "key": "2QEJ3JNR", "version": 134, "library": { "type": "group", "id": 334259, "name": "ALS 321 Project", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_321_project", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/334259/items/2QEJ3JNR", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/2QEJ3JNR", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/334259/items/W723GDV9", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } } }, "data": { "key": "2QEJ3JNR", "version": 134, "parentItem": "W723GDV9", "itemType": "attachment", "linkMode": "linked_url", "title": "Full Text PDF", "accessDate": "2015-04-19T20:53:18Z", "url": "http://physrev.physiology.org/content/90/1/47.full.pdf", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-04-19T20:53:18Z", "dateModified": "2015-04-19T20:53:18Z" } }, { "key": "W723GDV9", "version": 134, "library": { "type": "group", "id": 334259, "name": "ALS 321 Project", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_321_project", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/334259/items/W723GDV9", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/W723GDV9", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } }, "creatorSummary": "Dempsey et al.", "parsedDate": "2010-01-01", "numChildren": 3 }, "data": { "key": "W723GDV9", "version": 134, "itemType": "journalArticle", "title": "Pathophysiology of Sleep Apnea", "creators": [ { "creatorType": "author", "firstName": "Jerome A.", "lastName": "Dempsey" }, { "creatorType": "author", "firstName": "Sigrid C.", "lastName": "Veasey" }, { "creatorType": "author", "firstName": "Barbara J.", "lastName": "Morgan" }, { "creatorType": "author", "firstName": "Christopher P.", "lastName": "O'Donnell" } ], "abstractNote": "Sleep-induced apnea and disordered breathing refers to intermittent, cyclical cessations or reductions of airflow, with or without obstructions of the upper airway (OSA). In the presence of an anatomically compromised, collapsible airway, the sleep-induced loss of compensatory tonic input to the upper airway dilator muscle motor neurons leads to collapse of the pharyngeal airway. In turn, the ability of the sleeping subject to compensate for this airway obstruction will determine the degree of cycling of these events. Several of the classic neurotransmitters and a growing list of neuromodulators have now been identified that contribute to neurochemical regulation of pharyngeal motor neuron activity and airway patency. Limited progress has been made in developing pharmacotherapies with acceptable specificity for the treatment of sleep-induced airway obstruction. We review three types of major long-term sequelae to severe OSA that have been assessed in humans through use of continuous positive airway pressure (CPAP) treatment and in animal models via long-term intermittent hypoxemia (IH): 1) cardiovascular. The evidence is strongest to support daytime systemic hypertension as a consequence of severe OSA, with less conclusive effects on pulmonary hypertension, stroke, coronary artery disease, and cardiac arrhythmias. The underlying mechanisms mediating hypertension include enhanced chemoreceptor sensitivity causing excessive daytime sympathetic vasoconstrictor activity, combined with overproduction of superoxide ion and inflammatory effects on resistance vessels. 2) Insulin sensitivity and homeostasis of glucose regulation are negatively impacted by both intermittent hypoxemia and sleep disruption, but whether these influences of OSA are sufficient, independent of obesity, to contribute significantly to the “metabolic syndrome” remains unsettled. 3) Neurocognitive effects include daytime sleepiness and impaired memory and concentration. These effects reflect hypoxic-induced “neural injury.” We discuss future research into understanding the pathophysiology of sleep apnea as a basis for uncovering newer forms of treatment of both the ventilatory disorder and its multiple sequelae.", "publicationTitle": "Physiological Reviews", "publisher": "", "place": "", "date": "2010/01/01", "volume": "90", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "47-112", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1152/physrev.00043.2008", "citationKey": "", "url": "http://physrev.physiology.org/content/90/1/47", "accessDate": "2015-04-19T20:53:18Z", "PMID": "", "PMCID": "", "ISSN": "0031-9333, 1522-1210", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "en", "libraryCatalog": "physrev.physiology.org", "callNumber": "", "rights": "Copyright © 2010 the American Physiological Society", "extra": "PMID: 20086074", "tags": [], "collections": [ "CW6KGNNT" ], "relations": {}, "dateAdded": "2015-04-19T20:53:18Z", "dateModified": "2015-04-19T20:53:18Z" } }, { "key": "VW24RUU8", "version": 134, "library": { "type": "group", "id": 334259, "name": "ALS 321 Project", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_321_project", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/334259/items/VW24RUU8", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/VW24RUU8", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/334259/items/W723GDV9", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } } }, "data": { "key": "VW24RUU8", "version": 134, "parentItem": "W723GDV9", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed entry", "accessDate": "2015-04-19T20:53:18Z", "url": "http://www.ncbi.nlm.nih.gov/pubmed/20086074", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-04-19T20:53:18Z", "dateModified": "2015-04-19T20:53:18Z" } }, { "key": "B8ZW444N", "version": 133, "library": { "type": "group", "id": 334259, "name": "ALS 321 Project", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_321_project", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/334259/items/B8ZW444N", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/B8ZW444N", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } }, "creatorSummary": "Qaseem et al.", "parsedDate": "2014-08-05", "numChildren": 1 }, "data": { "key": "B8ZW444N", "version": 133, "itemType": "journalArticle", "title": "Diagnosis of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From the American College of PhysiciansDiagnosis of Obstructive Sleep Apnea in Adults", "creators": [ { "creatorType": "author", "firstName": "Amir", "lastName": "Qaseem" }, { "creatorType": "author", "firstName": "Paul", "lastName": "Dallas" }, { "creatorType": "author", "firstName": "Douglas K.", "lastName": "Owens" }, { "creatorType": "author", "firstName": "Melissa", "lastName": "Starkey" }, { "creatorType": "author", "firstName": "Jon-Erik C.", "lastName": "Holty" }, { "creatorType": "author", "firstName": "Paul", "lastName": "Shekelle" } ], "abstractNote": "Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the diagnosis of obstructive sleep apnea in adults.Methods: This guideline is based on published literature on this topic that was identified by using MEDLINE (1966 through May 2013), the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews. Searches were limited to English-language publications. The clinical outcomes evaluated for this guideline included all-cause mortality, cardiovascular mortality, nonfatal cardiovascular disease, stroke, hypertension, type 2 diabetes, postsurgical outcomes, and quality of life. Sensitivities, specificities, and likelihood ratios were also assessed as outcomes of diagnostic tests. This guideline grades the evidence and recommendations by using ACP's clinical practice guidelines grading system.Recommendation 1: ACP recommends a sleep study for patients with unexplained daytime sleepiness. (Grade: weak recommendation, low-quality evidence)Recommendation 2: ACP recommends polysomnography for diagnostic testing in patients suspected of obstructive sleep apnea. ACP recommends portable sleep monitors in patients without serious comorbidities as an alternative to polysomnography when polysomnography is not available for diagnostic testing. (Grade: weak recommendation, moderate-quality evidence)", "publicationTitle": "Annals of Internal Medicine", "publisher": "", "place": "", "date": "August 5, 2014", "volume": "161", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "210-220", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Ann Intern Med", "DOI": "10.7326/M12-3187", "citationKey": "", "url": "http://dx.doi.org/10.7326/M12-3187", "accessDate": "2015-04-19T20:51:51Z", "PMID": "", "PMCID": "", "ISSN": "0003-4819", "archive": "", "archiveLocation": "", "shortTitle": "Diagnosis of Obstructive Sleep Apnea in Adults", "language": "", "libraryCatalog": "Silverchair", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [ "CW6KGNNT" ], "relations": {}, "dateAdded": "2015-04-19T20:51:51Z", "dateModified": "2015-04-19T20:51:51Z" } }, { "key": "93G2ZA7N", "version": 133, "library": { "type": "group", "id": 334259, "name": "ALS 321 Project", "links": { "alternate": { "href": "https://www.zotero.org/groups/als_321_project", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/334259/items/93G2ZA7N", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/als_321_project/items/93G2ZA7N", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/334259/items/B8ZW444N", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2075492, "username": "knozaw14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/knozaw14", "type": "text/html" } } } }, "data": { "key": "93G2ZA7N", "version": 133, "parentItem": "B8ZW444N", "itemType": "attachment", "linkMode": "linked_url", "title": "Full Text PDF", "accessDate": "2015-04-19T20:51:51Z", "url": "http://annals.org/data/Journals/AIM/930624/0000605-201408050-00009.pdf", "note": "", "contentType": "application/pdf", "charset": "", "tags": [], "relations": {}, "dateAdded": "2015-04-19T20:51:51Z", "dateModified": "2015-04-19T20:51:51Z" } } ]